唾液腺显像半定量分析对^(131)I治疗分化型甲状腺癌患者后涎腺功能受损的预测评估及动态监测  

Semi-quantitative analysis of salivary gland scintigraphy for predictive evaluation and dynamic monitoring of impaired salivary gland function after ^(131)I treatment of DTC patients

作　　者：李泽阳 李贺松 赵潇逸 席永昌[2] 宋会民[2] 唐曼[2] 葛佳宁 LI Zeyang;LI Hesong;ZHAO Xiaoyi;XI Yongchang;SONG Huimin;TANG Man;GE Jianing(Chengde Medical University,Hebei Chengde 067000,China;Baoding No.1 Central Hospital,Hebei Baoding 071000,China.)

机构地区：[1]承德医学院,河北承德067000 [2]保定市第一中心医院,河北保定071000

出　　处：《现代肿瘤医学》2024年第6期1043-1047,共5页Journal of Modern Oncology

基　　金：河北省保定市科技计划(编号:2241ZF043)。

摘　　要：目的:通过放射性核素显像半定量分析技术,对^(131)I治疗前后分化型甲状腺癌(differentiated thyroid carcinoma,DTC)患者的唾液腺功能进行评估,探讨唾液腺显像(salivary gland scintigraphy,SGS)半定量指标对唾液腺功能损害的预测价值,以期开发可早期预测唾液腺功能损伤的有效指标。方法:回顾性研究2020年-2022年于保定市第一中心医院核医学科DTC术后、首次^(131)I治疗术后患者72例及术后未进行^(131)I治疗术的患者40例,测定其治疗前后SGS其15 min摄取率(uptake rate at 15 minutes,UR15‰)、摄取指数(concentrate index,CI)、唾液腺排泌率(maximum secretion ratio,MSR%)、最小排泌时间(time interval from stimulation to minimum count,T_(min))等参数,填写调查口腔干燥症状评估量表(The Oral Dryness-Severity Scale,ODSS),分析半定量参数与唾液腺损伤的关系,并寻找预测唾液腺功能损伤的有效指标。结果:72例DTC术后进行^(131)I治疗术的患者的双侧腮腺CI,双侧颌下腺UR15‰、CI、T_(min)统计学均无显著性差异(P>0.05);双侧腮腺UR15%、MSR%、T_(min),双侧颌下腺MSR%统计学有明显差异(P<0.05),双侧腮腺ΔMSR%(r=-0.58)、ΔT_(min)(r=-0.42)及双侧颌下腺ΔMSR%(r=-0.45)、ΔT_(min)(r=-0.33)与唾液腺损伤呈负相关。结论:DTC术后行^(131)I治疗术的部分患者可能存在唾液腺功能损伤,唾液腺排泄功能损伤先于摄取功能损伤出现,MSR%和T_(min)降低可提示唾液腺排泄功能损伤,CI、UR15‰可能提示摄取功能损伤。Objective:To evaluate the salivary gland function in patients with differentiated thyroid carcinoma(DTC)before and after ^(131)I therapy using semi-quantitative analysis of radionuclide imaging.This study aimed to explore the predictive value of semi-quantitative parameters derived from salivary gland scintigraphy(SGS)in assessing salivary gland damage and develop effective indicators for early prediction of salivary gland dysfunction.Methods:A retrospective study was conducted on 72 patients with DTC who underwent postoperative ^(131)I therapy and 40 patients who did not receive ^(131)I therapy after surgery in Baoding No.1 Central Hospital from 2020 to 2022.Semi-quantitative parameters,including the uptake rate at 15 minutes(UR15‰),concentrate index(CI),maximum secretion ratio(MSR%),and time interval from stimulation to minimum count(T_(min)),were measured using SGS before and after treatment.The Oral Dryness-Severity Scale(ODSS)was used to assess xerostomia symptoms.The relationship between semi-quantitative parameters and salivary gland damage was analyzed,and effective indicators for predicting salivary gland dysfunction were identified.Results:There were no significant differences in bilateral parotid CI,bilateral submandibular UR15‰,CI,and T_(min) in the 72 DTC patients who underwent ^(131)I therapy(P>0.05).However,significant differences were observed in bilateral parotid UR15%,MSR%,T_(min),and bilateral submandibular MSR%(P<0.05).Negative correlations were found betweenΔMSR%(r=-0.58),ΔT_(min)(r=-0.42)in bilateral parotid glands,ΔMSR%(r=-0.45),ΔT_(min)(r=-0.33)in bilateral submandibular glands,and salivary gland damage.Conclusion:Some patients with DTC who underwent ^(131)I therapy may experience salivary gland dysfunction.Impairment in salivary gland excretion precedes impairment in uptake function,and decreased MSR%and T_(min) may indicate salivary gland excretion dysfunction,while CI and UR15‰may suggest uptake function impairment.

关 键 词：分化型甲状腺癌 放射性涎腺炎 ^(131)I治疗术 唾液腺显像 半定量分析 

分 类 号：R736.1[医药卫生—肿瘤]